The Medicare Payment Advisory Commission (MedPAC) has submitted comments to the Centers for Medicare & Medicaid Services (CMS) on the proposed payment reform rule that was issued April 30. As part of the letter, MedPAC supports CMS’ proposed modifications to the structure of the payment rates for routine home care (RHC) as a “positive step toward better aligning hospice payments with the…pattern of hospice visits throughout an episode.” Relative to the Service Intensity Add-on (SIA) permitted for RN and Social Worker visits within the last seven days of life, MedPAC “urges CMS to permit these payments for hospice patients in nursing facilities because regardless of setting we would expect hospice patients to have increased needs for nursing support and symptom management in the last days of life.” The National Association for Home Care & Hospice (NAHC) is in the process of developing comments on the proposed regulation, which are due by 5 p.m. on June 29, but shares MedPAC’s concern about the disallowance of the SIA for patients in nursing facilities or skilled nursing facilities. The overriding goal of hospice payment reform should be to more appropriately reimburse hospice providers for the cost of delivering needed services rather than to pay them differentially based on the location of the patient’s residence or to discourage the provision of needed services.

The U.S. House Ways and Means Committee on Tuesday voted out of committee several Medicare-related bills, including one to repeal the Independent Payment Advisory Board instituted under the Affordable Care Act. The committee also approved legislation to extend the Independence at Home demonstration project for an additional two years and to repeal the medical device tax.

“Every one of these bills would fix a different part of Medicare, but all of them would change the very focus of Medicare,” said Ryan. Part of the problem, Ryan said, is that Medicare officials make decisions without adequately taking the views of seniors into consideration. Congress needs to give more control to seniors, he said, by passing these bills including repealing the Independent Payment Advisory Board.

“What we want less of is this bureaucratic meddling,” Ryan said. “That’s why one of these bills would repeal the Independent Payment Advisory Board, a board of 15 unelected bureaucrats that could cut Medicare’s payments to doctors and essentially ration care.”

Gentiva Hospice of Savannah, GA is currently hiring for a RN Manager of Clinical Practice! If you have recent Hospice experience, some Management background or a Hospice certification, and are open to relocation, this is a great opportunity for you to consider. If you are interested or know of someone you would recommend, please feel free to email Matt Rice at Matt.Rice@gentiva.com or call me at 615-429-7891.